Q4155
HCPCSMedicine & Other ServicesMatrix clarix flo allograft particulate amniotic membrane umbilical cord 25mg tissue
As billed by one hospital: “HB CLARIX FLO PER 1 MG_100@”
Based on the latest published hospital price files, code Q4155 (Matrix clarix flo allograft particulate amniotic membrane umbilical cord 25mg tissue) appears at 9 hospitals across 8 cities in 6 states with disclosed cash prices from $14.35 to $188. This is public hospital price transparency data, not a guaranteed estimate of your bill.
New to this? Read How to compare hospital prices by CPT code.
What this is
This is a non-surgical medical service — an injection or infusion, a therapy, a specialty test, or another treatment delivered by clinical staff.
What affects the price
Drugs and supplies used during the service are frequently billed on their own separate lines, so the total can exceed the price shown here. Ask which additional codes are expected.
Category: Medicine & Other Services
What the published prices show
Across the 6 hospitals that disclose a cash price for code Q4155, the median is $14.35, and half of the disclosed prices fall between $14.35 and $22.90 — about a 2× difference for the same billing code. The full disclosed range runs from $14.35 to $188. At 80% of the hospitals that publish both, the cash price is lower than the midpoint of the disclosed insurance-negotiated rates — so paying cash can sometimes beat using insurance for this service. Confirm with your plan first.
Published-price availability
A blank price (“—”) means a hospital names this service but did not publish a dollar amount — it is not a free service or a $0 price.
Compare Q4155 prices
Filter by hospital, city, setting, or payer — the summary and charts update with your filters.
Published cash prices for code Q4155 vary by about 13× across the 6 hospitals with disclosed prices here — from $14.35 to $188. Shopping around can matter.
Lowest cash price by hospital
- Van Wert Hospital$25.75
Cash price by city
Reflects your current filters.
- Roanoke · 1 hospital$14.35
- SE Roanoke · 2 hospitals$14.35
- Christiansburg · 1 hospital$14.35
- Van Wert · 1 hospital$25.75
- Lincolnton · 1 hospital$188
9 prices shown.
| Service | Hospital | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|---|
| Clarix flo per 1 mg_100@ Outpatient | Carilion Roanoke Community Hospital | Q4155 HCPCS | $41.00 | $14.35 | $20.54 – $38.95 | $38.95 | |
| Clarix flo per 1 mg_100@ Outpatient | Carilion Roanoke Memorial Hospital | Q4155 HCPCS | $41.00 | $14.35 | $20.54 – $38.95 | $38.95 | |
| Neoxflo or clarixflo 1 mg Outpatient | SUTTER CENTER FOR PSYCHIATRY | Q4155 HCPCS | — | — | $60.51 – $60.51 | — | |
| Clarix flo per 1 mg_100@ Outpatient | Carilion New River Valley Medical Center | Q4155 HCPCS | $41.00 | $14.35 | $20.54 – $38.95 | — | |
| Matrix clarix flo allograft particulate amniotic membrane umbilical cord 25mg tissue Outpatient | Atrium Health Lincoln | Q4155 HCPCS | $375 | $188 | $42.30 – $356 | — | |
| Neoxflo or clarixflo 1 mg Outpatient | IU Health Frankfort Hospital | Q4155 CPT | — | — | — | — | |
| Neoxflo or clarixflo 1 mg Outpatient | University of Chicago Medical Center | Q4155 HCPCS | — | — | — | — | |
| Clarix flo per 1 mg_100@ Outpatient | Carilion Giles Community Hospital | Q4155 HCPCS | $41.00 | $14.35 | $20.54 – $38.95 | — | |
| Neoxflo/Clarixflo Per 1 Mg Inpatient & outpatient | Van Wert Hospital | Q4155 HCPCS | $39.62 | $25.75 | — | — |
How to read these prices
- Cash price
- The discounted self-pay price for paying directly, without insurance.
- List price
- The hospital’s full undiscounted charge — rarely what anyone pays.
- Negotiated rate
- A rate for a specific insurer and plan; your share depends on your benefits.
- Allowed amount
- A historical reference for what was actually allowed, where disclosed.
Hospitals that publish Q4155 prices
Open a hospital to see this code in the context of its full published prices.
Code Q4155: frequently asked
- What does code Q4155 cost?
- Across the published hospital price files, the disclosed cash price for Q4155 ranges from $14.35 to $188. This is public hospital price transparency data, not a guaranteed estimate of your bill.
- Will this be my final bill?
- Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.
- What is code Q4155?
- Q4155 is the billing code hospitals use to identify "Matrix clarix flo allograft particulate amniotic membrane umbilical cord 25mg tissue" on their published price files. We use it to line up the same service across different hospitals.
- Why do Q4155 prices differ between hospitals?
- 9 hospitals across 6 states publish a price for Q4155 here, and even setting aside the outliers, most disclosed cash prices span roughly a 2× difference. Each hospital sets its own prices and negotiates separately with each insurer, so the disclosed price for the same code can vary widely from one hospital to another — and even between plans at a single hospital. Comparing the published figures is what this page is for; a difference does not by itself mean one hospital is better or worse.
- What this page is not
- It is not a quote, a guarantee, or medical advice. It shows what hospitals have published for this code, so you can compare and ask informed questions — your actual cost depends on your insurance, the exact services performed, and the care setting.